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Active Irrigation Device Manages Intracranial Bleeding

By HospiMedica International staff writers
Posted on 22 Jan 2019
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Image: An ICP monitoring system controls CSF drainage (Photo courtesy of IRRAS).
Image: An ICP monitoring system controls CSF drainage (Photo courtesy of IRRAS).
A novel controlled fluid exchange system allows neurosurgeons to actively manage intracranial pressure (ICP) and cerebrospinal fluid (CSF) drainage.

The IRRAS (Stockholm, Sweden) IRRAflow device is an ICP monitoring and drainage system designed to drain intracranial fluid in order to reduce ICP in patients when an external drainage and monitoring system is needed for less than 24 hours. The device consists of a reusable control unit and two sterile disposables, the IRRAflow tube set and IRRAflow catheter. Dynamic fluid management takes place in a closed-circulatory system, with pressure continuously monitored and adjusted through cyclical fluid irrigation and drainage, using the dual-lumen IRRAflow catheter.

As a result, the drainage rate can be actively guided and optimized for each patient. An aspiration bag is attached to the control unit tape measure, defining the height of the bag relative to the catheter’s tip position inside the patient’s head. The gravitational, unidirectional method of controlling the speed of CSF drainage results in no recirculation of the CSF. A default mode allows single bolus fluid injections (on a parallel saline line) in order to flush the catheter when it becomes clogged. CSF or intracranial fluid samples for testing can be taken from the aspiration port.

“IRRAS is focused on the treatment of hemorrhagic strokes that constitute about fifteen percent of all strokes, but account for over forty percent of stroke associated deaths,” said Kleanthis Xanthopoulos, PhD, executive chairman of IRRAS. “This is a global health problem that results in immense financial stress to the healthcare system. IRRAflow can help address these serious brain pathologies and provide patients with improved solutions with less invasiveness, more efficacy, and continuous ICP monitoring that will hopefully translate into saved lives.”

External ventricular drains (EVDs) are vital tools for managing ICP during emergency situations, draining excess fluid, an important part of the recovery of such critically ill patients. Unfortunately, most EVDs are generally primitive systems that rely solely on gravity alone, and as a result, they have been plagued by blockages that can lead to inefficient drainage and other complications.

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